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Diabetes Care:尿酸是1型糖尿病患者肾功能、心血管事件和死亡率的独立危险因素

2019-04-03 xing.T 网络

在T1D个体中,较高的UA水平与肾功能、CVE和死亡率下降的风险较高相关,而与其他危险因素无关。该研究结果表明,UA在T1D患者的危险分层中具有很好的作用。

以前的研究提供了关于尿酸(UA)在风险预测中作用不确定的结果。近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员旨在提高UA预测值的功效和精确度,以降低1型糖尿病(T1D)患者肾功能、血管事件(CVE)和死亡率下降的风险。

研究人员测量了670例T1D患者血浆UA水平,这些患者具有不同程度的白蛋白尿,范围从正常白蛋白尿到大量白蛋白尿。研究人员分析了UA与估计的肾小球滤过率(eGFR)下降≥30%、CVE和死亡率之间的关联。中位随访时间为5.3年[四分位间距(IQR)为2.7-6.2年],eGFR下降≥30%,白蛋白尿状态进展为5.8年(2.5-6.4年),CVE为5.1年(4.7-5.6年),死亡率为6.2年(5.8-6.7年)。并对UA相关结果和变量的单变量和多变量关联进行了报道。

UA水平加倍与eGFR下降≥30%(n=89)(HR为3.18 [IQR为1.71-5.93]; P<0.001)、CVE(n=94)(HR为2.25[调整分析中IQR为1.20-4.21]; P=0.011)和死亡率(n=58)(HR为2.58 [IQR为1.12-5.90]; P=0.025)的风险较高相关。在包括常规危险因素的调整模型中加入UA可使相对综合判别指数对eGFR下降≥30%提高12.6%(P<0.001),对CVE提高6.5%(P=0.010),对死亡率提高11.8%(P=0.003)。在调整分析中,UA水平加倍也与eGFR的急剧下降(P<0.0026)和尿白蛋白-肌酸酐比率增加(P<0.0027)相关。

在T1D个体中,较高的UA水平与肾功能、CVE和死亡率下降的风险较高相关,而与其他危险因素无关。该研究结果表明,UA在T1D患者的危险分层中具有很好的作用。

原始出处:


Sascha Pilemann-Lyberg,et al.Uric Acid is an Independent Risk Factor for Decline in Kidney Function, Cardiovascular Event and Mortality in Patients With Type 1 Diabetes.Diabetes Care.2019.https://doi.org/10.2337/dc18-2173

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    2019-12-01 智慧医人
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    2019-11-24 yese
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    2019-04-03 misszhang

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